Laserfiche WebLink
OWNER OF SITE <br /> CRISP TANK TESTING 4 <br /> 2004 Piccoli Rd. #9 � � J J - <::71 <br /> Stockton, CA 95205 g y yn HORNER EASY TESTING METHOD ADDRESS <br /> WORK SHEET76 <br /> i� <br /> CITY-STATE•ZIP CODE <br /> J <br /> OWNER OF TANKS <br /> TANK No. TEST LEVEL PRODUCT �'.- ` CAPACITY t _CHART CAL " _ �� > (Aj <br /> � r <br /> 'J- ADDRESS <br /> -7 TEMP CAL <br /> MEASURED GRAVITY PRODUCT TEMP COEFFICIENT �1 ! ? ?�� <br /> Air Temp <br /> TEST LEVEL LEVEL GAIN• x(A) LEVEL TEMP. TEMP. GAIN♦ x`B) TEMP. FINAL CITY•STATE-ZIPCODE <br /> NO, START END LOSS— x(A) RESULT START END LOSS— x B) RESULT RESULT TIME <br /> r <br /> X <br /> i• OPERATORS NAME AT SITE <br /> / T <br /> i <br /> / r - X ,1 <br /> •9 <br /> i y ! STEM <br /> % � ) 1 r TYPE of SYSTEM ,. <br /> f <br /> X ❑SUBMERGE ❑SUCTION <br /> _ s X �� <br /> 6 r (� �; i r��-� LENGTH OF COLOR CODE OF PROOF: <br /> i / J r / `� FILL PIPE <br /> !� ( CLEAR ORANG <br /> RED <br /> DIAMETER OF TANK <br /> _ ❑ (METAL <br /> J X " ❑ FIBERGLA <br /> 3 / C^ 2 U . d /`* �(j i ✓ .��G s �r ' r, y TYPE OF RECOVERY SYSTEM <br /> _ s []BALANCE ❑REO JACKET [:)HEAL <br /> ot) ��`t �'�� WATER LEVEL IN TANK Liquid level <br /> V • <br /> (1 <br /> _ C. DEPTH OF GROUND WATER (IF KNOWN) <br /> X L_ l <br /> DATE/TIME STORAGE SYSTEM FILLED <br /> nK STATION LOCATIONDATE TIME <br /> CERTIFIED TIGHT (�,' -- • <br /> 1/V ' <br /> ADDRESS LE <br /> ���c� �� n� I AK RATE PER HOUR 4 AGE OF TANKS <br /> �` <br /> _ CITY �' � , . <br /> STATE OPERATOR- - / AGE OF LINES <br /> DATE SIGNATURE <br /> TEST INC F•U+n rr ni.r� <br />